Description

Application for Authority to Transact Business - Business/Professional Secretary of State - Corporation Division - 255 Capitol St. NE, Suite 151 - Salem, OR 97310-1327 sos.oregon.gov/business - Phone: (503) 986-2200 Check the appropriate box below: FOREIGN BUSINESS CORPORATION (Complete only 1, 2, 3, 4, 5, 6, 7, 8, 9, 11) FOREIGN PROFESSIONAL CORPORATION (Complete all items) REGISTRY NUMBER: For office use only In accordance with Oregon Revised Statute 192.410-192.490, the information on this application is public record. W e must release this information to all parties upon request and it will be posted on our website. For office use only Please Type or Print Legibly in Black Ink. Attach Additional Sheet if Necessary. 1) NAME OF CORPORATION: NOTE: Must be identical to the name of record in home jurisdiction. 2) REGISTRY NUMBER IN HOME JURISDICTION 8) ADDRESS FOR MAILING NOTICES: OR: CERTIFICATE OF EXISTENCE (ATTACHED) (Please provide a web-verifiable registry number from the entitys home jurisdiction. Certain states, such as Delaware and New Jersey, do not provide status information online. Entities from such places must instead attach an official certificate of existence, current within 60 days of delivery to this office.) 3) DATE OF INCORPORATION: DURATION, IF NOT PERPETUAL: 9) NAME AND ADDRESS OF PRESIDENT AND SECRETARY: President: 4) STATE OR COUNTRY OF ORGANIZATION: Address: 5) ADDRESS OF PRINCIPAL OFFICE OF THE BUSINESS: (Address, city, state, zip) Secretary: Address: 6) NAME OF OREGON REGISTERED AGENT: 7) REGISTERED AGENT'S PUBLICLY AVAILABLE ADDRESS: (Must be an Oregon Street Address which is identical to the registered agenbusiness office.) PROFESSIONAL CORPORATION ONLY 10) PROFESSIONAL/BUSINESS SERVICES: (List professional service(s) and other business services, if applicable, to be rendered.) 11) EXECUTION: (Must be signed by at least one officer or director.) I declare as an authorized signer, under penalty of perjury, that this document does not fraudulently conceal, fraudulently obscure, fraudulently alter or otherwise misrepresent the identity of the person or any officers, directors, employees or agents of the corporation. This filing has b een examined by me and is, to the best of my knowledge and belief true, correct, and complete. Making false statements in this document is against the law and may be penalized by fines, imprisonment or both. Signature: Printed Name: Title: CONTACT NAME: (To resolve questions with this filing.) FEES Required Processing Fee $275 PHONE NUMBER: (Please include area code.) Processing Fees are nonrefundable. Please make check payable to Corporation Division. Free copies are available at sos.oregon.gov/business, using the Business Name Search program. 50 - Application for Authority to Transact Business - Business Professional (11/17) American LegalNet, Inc. www.FormsWorkFlow.com